Kegels: Learning to Put Your Pelvic Floor Muscles on Auto-Pilot

Here’s something you may not know about a healthy pelvic floor muscles: they work on auto-pilot!What do we mean by this? We mean that healthy pelvic floor muscles automatically work in concert to keep urine in your bladder until you choose to urinate. They also work together when you go to the bathroom to allow urine to flow until the bladder is empty.Specifically, when you are not exerting yourself (by exercising, lifting heavy objects, sneezing) a certain type of pelvic floor muscles, the “slow twitch muscles” (also called Type I muscles) support and hold all your pelvic organs in place. These muscles, also called “marathoner muscles” because they have the endurance to keep supporting your pelvic organs all day and night, keep the muscle rings around your urethra tight so no urine leaks out. In a woman with healthy pelvic floor muscles, these Type I muscle groups function automatically, without any conscious thought or control from the brain … hence the term auto-pilot.

At the same time, you have another group of muscles, called Type II muscles, or “fast twitch muscles,” that move into action whenever your intra-abdominal pressure increases. This increase in pressure occurs when you sneeze, cough, lift a heavy object, or even just step off a curb. With this increase in pressure, your Type II muscles, also called “sprinter muscles,” engage and give added support to your pelvic organs. For instance, these muscles tighten the muscle ring around your urethra (also called a sphincter) and prevent urine from being pushed out of the bladder by the increased pressure. Again, for a woman with healthy pelvic floor muscles this reaction occurs automatically.

Women’s Urinary Incontinence and Weak Pelvic Floor Muscles
If you suffer from women’s urinary incontinence or pelvic organ prolapse, then your pelvic floor muscles have lost their ability to function on “auto-pilot.” With stress incontinence your “sprinter muscles” don’t engage quickly or strongly enough to prevent urine leakage when you cough, sneeze, or laugh. In the case of overactive bladder (OAB) or urge incontinence, both you “sprinter” and “marathoner” muscles are not offering enough support when your bladder muscles become overly active. With pelvic organ ploapse, your marathoner muscles are not offering enough constant support, so pelvic organs sag out of place.

In other words you have lost your pelvic floor “auto-pilot” function. That’s the bad news.

The good news is that you can use pelvic floor muscle exercises, like Kegels to strengthen and tone both kinds of pelvic muscles. Exercise science and research both indicate that it is possible to regain that “auto-pilot” function in your pelvic floor muscles if you follow the right muscle retraining program (and depending on the severity of your condition.).

Studies have shown Kegels to be an effective first-line conservative therapy for all types of women’s urinary incontinence, decreased sexual sensation, and pelvic organ prolapse (read the statisticshere). You can also combine exercises like Kegels with other conservative measures, including medication, timed voiding, diet modification, smoking cessation, and weight loss for even better results.

The takeaway message from this article is that by strengthening and retraining your pelvic floor muscles, you can go return to a healthy lifestyle free of urinary leakage without conscious thought on your part. You can go back to living high and dry on auto-pilot!

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